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PubMed1993

The effect of otitis media with effusion on the masking-level difference and the auditory brainstem response.

This study investigated the masking-level difference (MLD) and auditory brainstem response (ABR) in a group of children with a history of otitis media with effusion (OME) and a control group of children with no known history of ear disease. All children had normal hearing at the time of testing. The main goal of the study was to determine whether there was an association between a reduced MLD in the OME children and an abnormal ABR (in terms of prolonged absolute or interwave intervals, or interaural differences in the ABR waveforms). The results indicated that the group of children having a history of OME had significantly reduced MLDs and had significantly prolonged waves III and V, and I-III and I-V interwave intervals. The correlations between MLD and delays in absolute wave or interwave intervals were not significant. However, some correlations between interaural asymmetries of the interwave intervals and the MLD were significant. The results suggest that the reduction in MLD found in children having a history of OME may be related to abnormal brainstem processing.

Audiometry, Pure-Tone↗
PubMed1999

Hypersensitivity to sound--questionnaire data, audiometry and classification.

This study included consecutive case histories and audiometry of 100 patients with hypersensitivity to sounds. There are several different conditions with the symptom of hypersensitivity to sounds. Hyperacusis is one of those and is seldom described in the literature. The term hyperacusis is often used synonymously with hypersensitivity to sound. We propose that there is a specific condition that could be termed hyperacusis. Hyperacusis is often elicited by loud sounds or by a number of other traumata or diseases. It is not typical of occupational noise exposure (with the exception of exposure to music). The typical patient is relatively young, the mean age being approximately 10 years less than for a population of patients with tinnitus or noise-induced hearing loss. In addition to hypersensitivity to sound, the patients often suffer from tinnitus (86%). Sounds are frequently painful and exposure to loud sounds worsens the condition for some time. The patients often have headaches. Pure tone audiograms show normal hearing or a slight high tone loss. The uncomfortable loudness level is markedly decreased, mostly less than 90 dB HL. Patients with hyperacusis may also be divided into those hypersensitive to the loudness of sounds with a decreased pure tone uncomfortable loudness level and those hypersensitive to certain specific sounds irrespective of loudness showing relatively high pure tone uncomfortable loudness levels and decreased uncomfortable loudness levels to specific sounds. With a careful history other conditions with the symptom of hypersensitivity to sound can be excluded.

Adolescent↗
PubMedDate not supplied

Bone-conduction masking for threshold assessment in auditory brain stem response testing.

The viability of applying Sensorineural Acuity Level (SAL) audiometry to auditory brain stem response (ABR) testing was investigated using 38 subjects with normal hearing, conductive, sensorineural, and mixed hearing losses. The stimuli were clicks, 4000, 2000, and 1000 Hz tone-pips. After ABR thresholds (ABRt) were obtained, bone-conducted noise was used to mask the response to a stimulus 5 dB above ABR threshold (ABRt + 5). Estimates of behavioral bone-conduction thresholds were made by observing the amount of noise needed to mask ABRt + 5. Estimates of behavioral air-conduction thresholds were based upon ABRt. Results indicated that ABRt was within +/- 10 dB of behavioral air-conduction threshold across subject groups at least 74% of the time for all tone-pip stimuli. ABRt was within +/- 15 dB of the pure-tone average of 1000, 2000, and 4000 Hz 75% of the time when click stimuli were used. Derived bone-conduction thresholds were within +/- 10 dB of the actual bone-conduction threshold at least 73% of the time for all stimuli. It was concluded that, when used in a conservative manner, the application of SAL audiometry to ABR testing may increase the reliability and confidence with which decisions are made concerning the type and degree of hearing loss in difficult-to-test patients.

Adult↗
PubMedDate not supplied

Comorbidity of central auditory processing disorder and attention-deficit hyperactivity disorder.

UNLABELLED: Research has indicated that children with attention-deficit hyperactivity disorder (ADHD) demonstrate significant difficulty on tasks used to assess central auditory processing skills. These findings have raised the question of whether ADHD and central auditory processing disorder (CAPD) represent a singular disorder. OBJECTIVE: The current study explored the incidence of ADHD in a group of 30 children who met diagnostic criteria for CAPD. METHOD: Consecutive referrals specifically for this project were assessed on a variety of measures. In addition, rating scales were completed by teachers and structured interviews were completed with parents. RESULTS: Results indicate that although the incidence rate of ADHD (50%) in this sample significantly exceeds that found in the normative population (p < .001), not all children with CAPD demonstrated behaviors consistent with diagnostic criteria for ADHD. Furthermore, there was a low incidence of any other behavioral disorder in this sample. In contrast, it was found that the sample as a whole demonstrated impaired language abilities. No significant differences emerged across cognitive, auditory, or language measures. CONCLUSION: This study further supports the need for increased collaboration of those professionals who work with these children given the extent of overlap of language and behavioral difficulties in this sample.

Adolescent↗
PubMed1999

Some psychological aspects of tinnitus.

Tinnitus rarely can be cured. The patient, however, needs help to avoid countless ineffective treatments and considerable cost. The clinical examination of patients with severe and chronic tinnitus must include associated psychological disturbances. After all medical and audiological treatments have failed, tinnitus patients often are advised to "learn to live with it." The aim of psychosocial treatment is assisting patients in the identification of aggravating factors in tinnitus and teaching them various coping skills.

Adaptation, Psychological↗
PubMedDate not supplied

Masking level difference: another tool for the evaluation of peripheral and cortical defects.

Masking level difference (MLD) due to binaural unmasking was measured for speech signals (5-word meaningful sentences) masked by broad-band noise. Tests were carried out in a group of patients with unilateral cerebral lesions of vascular origin and apparently normal pure-tone audiograms (CNS patients), in a control group (normally hearing young adults) and in 5 other groups of patients (conductive symmetrical hearing loss, conductive asymmetrical hearing loss, bilateral presbyacusis, unilateral sudden deafness, Menière's disease). Testing pattern implied three or more S/N ratios in the listening conditions, of SmNm, Sdelta tNo and SmNu (noise correlated), and the speech signal intensity was 70 dB SPL re 20 muPa for the control group, whilst for the pathological cases, speech level intensities were established by means of alternate binaural loudness balance and simultaneous balancing median-plane localization procedures to assess subjective suprathreshold sound image localization at the midline. The results obtained in the control group and in the patients are discussed. With specific reference to the CNS patients, a statistically significant tendency was evident for the binaural condition to produce more MLD when the ear leading in time was ipsilateral to the normal hemisphere. The importance of this and of sensitized speech testing methods in CNS disorders is discussed on the basis of the results obtained in the CNS patients.

Acoustic Stimulation↗
PubMedDate not supplied

A test-retest reliability study on clinical measurement of masking level differences.

Measurement of binaural release from masking was studied in 30 normal and 10 hearing-impaired subjects to determine the test-retest reliability of masking level differences measured with a clinically feasible technique on generally available clinical equipment. The instrumentation/methodology was found to elicit reliable, consistent, rapid measurements for both 500-Hz and speech (spondaic) stimuli which were comparable with those generally reported in the literature as laboratory-conducted experiments.

Acoustic Stimulation↗
PubMed1992

Influence of masker bandwidth on binaural masking level differences.

Masking level differences (MLDs) were investigated using masking noise with 160 Hz (amplitude-modulated noise) and 600 Hz (filtered-random noise) bandwidth. One hundred normally hearing subjects received the MLD test under both types of noise. Significant differences between noise types were observed in both N0S pi and N pi S0 conditions; MLDs were larger in amplitude-modulated noise. Consideration of these differences would indicate that older MLD norms based solely on filtered-random noise are invalid for amplitude-modulated noise especially where bandwidth differences in the noise exist. Were the norms for 600-Hz-wide filtered-random noise to be applied to results of MLD testing performed using 160-Hz-wide amplitude-modulated noise, patients with lesions in the central auditory pathway might exhibit normal or borderline normal results. Clinical MLD norms established on one type of noise should not be used to interpret MLD results obtained using a different type of noise.

Adolescent↗
PubMed1991

Correlations between self-assessed hearing handicap and standard audiometric tests in elderly persons.

The relationship between self-assessed hearing handicap and audiometric measures using pure-tone and speech audiometry was studied in a group of elderly persons representative of an urban Swedish population. The study population consisted of two cohorts, one of which was followed longitudinally. Significant correlations between measured and self-assessed hearing were found. Speech discrimination scores showed lower correlations with the self-estimated hearing than pure-tone averages and speech reception threshold. Questions concerning conversation with one person and concerning difficulty in hearing the doorbell showed lower correlations with measured hearing than the other questions. The discrimination score test is an inadequate tool for measuring hearing handicap.

Aged↗
PubMed1993

Comparing the level of the acoustic distortion product 2f1-f2 with behavioural threshold audiograms from normal-hearing and hearing-impaired ears.

The level of the acoustic distortion product, 2f1-f2, was measured across frequency from two different groups of adults: (1) a group of 57 drawn from the university population who considered that they had normal hearing and (2) a group of 26 patients referred from the ENT Department of the County Hospital. These patients complained of reduced 'quality' of hearing, but no organic condition had been diagnosed to explain it. Behavioural audiograms were obtained for both groups. In both groups of listeners the distortion frequency sweep is related to the respective subjective threshold audiogram. In subjects from whom distortion can be recorded across a wide frequency range, acoustic distortion product level and auditory sensitivity were significantly correlated in one-third of the subjects. In hearing-impaired patients acoustic distortion is usually detectable across frequency regions of normal hearing, but falls below the noise floor if hearing threshold levels are above 15-20 dB.

Adolescent↗
PubMed1975

A profile for managing sensory integrative test data.

A concise method for compiling a data profile from a general sensory integrative test battery has been presented. Subtests from each test used were categorized according to the sensory integrative and motor functions being tested. These categories have been defined and include: tactile-kinesthetic perception, visual perception-figure ground, visual perception-constancy, ocular control, gross motor control, fine motor control, integration of function-two sides of the body, orientation in space, body awareness, and auditory discrimination. A method for converting the various scores into descriptive terminology is provided in which the test results are reported as above age expectancy, appropriate for age, somewhat deficient for age, and markedly deficient for age. The clinical implications of the technique are discussed.

Auditory Perception↗
PubMed2006

Effect of attentional state on frequency discrimination: a comparison of children with ADHD on and off medication.

Debate continues over the hypothesis that children with language or literacy difficulties have a genuine auditory processing deficit. Several recent studies have reported deficits in frequency discrimination (FD), but it is unclear whether these are genuine perceptual impairments or reflective of the comorbid attentional problems that exist in many children with language and literacy difficulties. The present study investigated FD in children with attention deficit hyperactivity disorder (ADHD) when their attentional state was altered with stimulant medication. Auditory thresholds were obtained using FD and frequency modulation detection (FM) tasks. In the FD task, participants judged which of 2 pairs contained a high-low frequency sound, and in the FM task, children judged which of two tones "wobbled" (i.e., modulated). Children with ADHD had significantly poorer and more variable FD performance when off compared to on stimulant medication, and did significantly worse than controls on all FD runs when off but not on stimulant medication. However, children with ADHD did not differ from controls on the FM task. These findings demonstrate that certain auditory discrimination tasks are influenced by the child's attentional status. In addition, significant relationships between FD and measures of language and reading were abolished when comorbid attentional difficulties were taken into account. The study has implications for design and interpretation of studies investigating links between auditory discrimination and difficulties in language and literacy.

Age Factors↗
PubMed1989

[Dysphatic development: clinical importance and neurological background].

The timely treatment of children with developmental dysphasia is important in the prevention of subsequent learning and behaviour disorders. The pathophysiology of developmental dysphasia is complex and depends on age. In the preverbal and early verbal phase the severity of the clinical picture is determined by accompanying motor function pathology (simple motor function, dysarthria, general and oral dyspraxia) and by receptive pathology (hearing, and auditory perception). In the verbal period linguistic problems become more prominent (syntax, morphology, semantics and verbal memory), these problems might be accompanied by oral motor symptoms. The different developmental language syndromes become more apparent with time. After kindergarten age the oral motor and perceptual problems diminish, but the language disorders, that influence communication and scholastic learning, remain. In a small number of children without oral motor, perceptual and memory problems, there exists a 'bare or nuclear syndrome', a so called 'pure dysphasia', without other neurological signs. In these children there is perhaps a genetically determined developmental disorder on a restricted neuronal level (no brain damage!). In more than half of the patients this syndrome is accompanied by other neurological signs, predominantly pointing to the left cerebral hemisphere. Furthermore there can be signs from the right cerebral hemisphere, the corpus callosum and from the afferent fibers systems for auditory perception. The nature and causes of these disorders are extremely variable, so that one cannot speak of the neural substrate or the pathogenesis. The diagnosis and the treatment can optimally only be performed by an experienced team, the expertise of which has to penetrate into the school education system.

Aphasia↗